EP1017447B1 - Medizinische elektrische zuleitung - Google Patents

Medizinische elektrische zuleitung Download PDF

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Publication number
EP1017447B1
EP1017447B1 EP98942218A EP98942218A EP1017447B1 EP 1017447 B1 EP1017447 B1 EP 1017447B1 EP 98942218 A EP98942218 A EP 98942218A EP 98942218 A EP98942218 A EP 98942218A EP 1017447 B1 EP1017447 B1 EP 1017447B1
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EP
European Patent Office
Prior art keywords
electrode
medical electrical
electrical lead
insulator
ring
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
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EP98942218A
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English (en)
French (fr)
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EP1017447A1 (de
Inventor
Karel F. A. Smits
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Medtronic Inc
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Medtronic Inc
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Publication of EP1017447A1 publication Critical patent/EP1017447A1/de
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N1/057—Anchoring means; Means for fixing the head inside the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N2001/0585—Coronary sinus electrodes

Definitions

  • This invention relates to the field of body implantable medical device systems, and in particular to a body implantable medical device system which includes a medical electrical lead particularly designed for implantation into the coronary sinus.
  • Modern electrical therapeutic and diagnostic devices for the heart such as pacemakers, cardiovertors, and defibrillators, for example, require a reliable electrical connection between the device and a region of the heart.
  • a medical electrical "lead” is used for the desired electrical connection.
  • Transvenous leads are positioned through the venous system to attach or electrically connect at their distal end to the heart. At their proximal end, they are connected to typically an implantable pulse generator. Such leads normally took the form of a long, generally straight, flexible, insulated conductor. Among the many advantages of a transvenous lead is that it permits an electrical contact with the heart without physically exposing the heart itself, i.e., major thoracic surgery is not required.
  • transvenous lead used is often varied depending upon the region of the heart to which it is to be connected.
  • U.S. Patent 4,402,330 of Lindemans discloses a body implantable lead in which the lead body has a J-curve and the distal electrode has a permanent bend. In such a manner, the lead is configured to electrically connect to the right atrium.
  • transvenous medical electrical lead which may provide an electrical connection to the left atrium.
  • the left atrium cannot, at present, be transvenously accessed with a lead for chronic implantation due to the direction of blood flow and the present limitations of materials.
  • blood flows through the right side of the heart (atrium and ventricle), through the lungs, through the left side of the heart (atrium and ventricle) and then through the rest of the body, including the brain, before returning again to the right side of the heart.
  • Implanted objects often cause minor blood clots and thrombus to form in the blood.
  • any clots may, on occasion, dislodge and be released into the bloodstream. Because the blood circulates directly from the left atrium and ventricle to the brain, any clots, however minor, could have serious consequences if they were to reach the brain, e.g. a stroke. In contrast, any clots released from an object implanted in the right side of the heart would simply travel to the lungs, where they would lodge without any serious risk. Thus at present, chronic transvenous leads may not be safely implanted within the left side of the heart.
  • the left side of the heart accounts for the majority of the heart's hemodynamic output.
  • the left ventricle has a greater wall thickness (10-20 mm as compared to 1-5 mm) than the right side. This, of course, is reasonable given that the left side of the heart must pump blood throughout the body while the right side only pumps blood through the lungs.
  • DE-U-9209100 discloses a lead for implantation in the AV node region, having a positionable electrode.
  • U.S. Patent No. 5,423,772 of Lurie et al. discloses a coronary sinus catheter having three sections. Each section has varying degrees of flexibility, with the proximal reinforced section being stiffer than an intermediate section, the intermediate section being stiffer than the softened tip section. The catheter also is curved, with the curve beginning in the intermediate section, the curve further continuing into the softened tip section, where the radius of curvature decreases, i.e., the catheter becomes more curved closer to the tip.
  • a still further object of the present invention is to provide a medical electrical lead having an electrode positioned so that when the lead is implanted into the coronary sinus the electrode is positioned against the coronary sinus wall.
  • a still further object of the present invention is to provide a medical electrical lead having an electrode which may be positioned along a selected portion of the coronary sinus wall, such as the lower portion of the coronary sinus wall and thus be able to electrically communicate with the left ventricle, or the upper portion of the coronary sinus wall and thus be able to electrically communicate with the left atrium.
  • a still further object of the present invention is to provide a medical electrical lead having an electrode which may be positioned along a selected portion of the coronary sinus wall but which will minimize the diminishment of any blood flow through the coronary sinus.
  • the present invention comprises a transvenous lead specifically designed for coronary sinus implantation.
  • the invention provides a medical electrical lead comprising means for electrically coupling to a pulse generator a lead body coupled to the means for electrically coupling, the lead body having a first end, a second end and an insulator covering a conductor between the first end and the second end, the insulator having an insulator diameter; and an electrode/anchoring section positioned about the second end of the insulator, the electrode/anchoring section having an electrode coupled to the second end of the conductor, the electrode positioned on a first side of the insulator; characterised by ring means for maintaining the electrode in contact with a blood vessel wall, the ring means having a ring means outer diameter, the ring means outer diameter greater than the insulator diameter.
  • the ring is constructed so as to be readily pliable and bent.
  • the ring functions to wedge or fix the lead within the coronary sinus in such a manner that the electrode is pushed against the vessel wall. Because the ring has a central lumen, however, the flow of blood through the vessel is not impeded.
  • the electrode is positioned on the ring itself.
  • the distal portion of the lead features a pre bent nose to assist in the positioning of the lead into the coronary sinus.
  • the nose may be oriented relative to the ring in any acceptable manner to permit the ring and the electrode to be properly positioned relative to anywhere along the coronary sinus wall.
  • a medical electrical lead comprising means for electrically coupling to a pulse generator; and a lead body coupled to the means for electrically coupling, the lead body having a first end and a second end and an insulator covering a conductor between the first end and the second end, the insulator having an insulator diameter; the lead body having an electrode coupled to the second end of the conductor, the electrode positioned on a first side of the insulator; characterised by arc means for maintaining the electrode in contact with a blood vessel wall, the arc means comprising a pair of oppositely disposed arcs extending from a side of the insulator in a direction around the lead body.
  • FIG. 1 is a perspective view of a lead according to the present invention.
  • lead 1 essentially has two portions: a connector portion 2 and a lead body portion 3.
  • Distal end of lead body portion features an electrode/anchoring section 4.
  • Connector portion 2 is a standard pacing connector, such as an IS-1 or an IS BI-2, and is used to couple the lead to a pulse generator, as shown.
  • Lead body portion 3 is preferably constructed using an insulative sheath of a biocompatible polymer, such as silicone, and a coiled conductor of a biocompatible material, such as MP35N.
  • Lead body portion 3 couples connector portion 2 to electrode/anchoring section 4.
  • the lead body may additionally feature pacing, sensing or defibrillation electrode 5.
  • the electrode/anchoring section features a fixation ring 5 disposed on first side of the lead and an electrode 10 disposed on the opposite side of the lead.
  • the fixation ring is disposed at an oblique angle 98 relative to the axis of the lead body.
  • ring 5 is angled 60 degrees relative to the axis of the lead body and in the proximal direction, although any angle between approximately 90 and 30 degrees may be selected.
  • This angling of the ring is an important feature of the present invention because it assists in maintaining the lead in position once properly placed. That is, the ring acts like a type of barb to thereby resist proximal movement of the lead.
  • Electrode 10 is constructed using spherical platinum porous powder which has further a platinum black electroplate thereon as is well known in the pacing art.
  • the electrode may further be constructed having a cavity into which is disposed a monolithic controlled release device therein to elute or dispense a drug, such as the sodium salt of dexamethasone, from the electrode into the surrounding tissues, as is well known in the pacing art.
  • a drug such as the sodium salt of dexamethasone
  • the electrode may be treated with a very slightly soluble in water steroid, such as beclomethasone dipropionate anhydrous.
  • the steroid is applied to the surface of the electrode which contacts tissue when implanted. Further details of such a coating process may be found in U.S. Patent Application of Williams "Medical Electrical Lead” Serial Number 08/605,591.
  • FIG. 2 is an end view of the lead shown in FIG. 1 and best shows the orientation of the fixation ring 5 and electrode 10.
  • ring 5 extends from a first side of electrode/anchoring section 4 to the opposite side. Ring 5 is positioned so as to be tangent to the outer surface of the electrode/anchoring section.
  • Electrode/anchoring section 4 preferably is constructed of silicone, and the ring is also preferably constructed of silicone. Ring 5 may have a thickness 90 of anywhere between approximately 0.5 - 3 millimeters, with 1 millimeter preferred, a width W (depicted in FIG. 1) anywhere between approximately 0.5 - 4 millimeters, with 2 millimeters preferred, and an outer diameter 91 of anywhere between approximately 6 - 8 millimeters.
  • Electrode/anchoring section 4 may have an outer diameter 92 of anywhere between approximately 1-3 millimeters, with 2 millimeters preferred.
  • Such small dimensions of the present invention are critical to the effective operation of the lead due to the small sizes of the cardiac veins.
  • a typical coronary sinus is 10 millimeters at its largest diameter (near the outflow to the right atrium) and narrows until it has a diameter of between approximately 2 - 3 millimeters and merges to the great cardiac vein.
  • the coronary sinus vein has a typical length of between 4 - 6 centimeters.
  • the fixation of a lead within the coronary sinus is complicated by the fact that, unlike a heart chamber where the fibrotic tissue response is used to assist lead fixation, no such fibrotic response can be expected in the vein. As such no fibrotic tissue response is available to assist in lead fixation.
  • FIG. 3 depicts the distal end of the lead shown in FIG. 1 implanted in the coronary sinus and details the operation of the fixation ring.
  • the ring is sized to wedge the electrode/anchoring portion against the opposite side of the coronary sinus wall.
  • the lumen through the ring permits blood to flow unimpeded, as depicted by arrows 12, 13.
  • the ring and electrode/anchoring section are oriented in a tangential manner so as to maximize the lumen through the ring and minimize the likelihood that there will be any other passageways for blood to flow through once the lead is implanted into the blood vessel.
  • shunted and interrupted blood flow can possibly lead to the formation of thrombosis, which may hinder blood flow to the point that stagnation occurs in the vessel. The health of the surrounding tissue would be impacted.
  • FIG. 4 is an end view of the lead shown in FIG. 3.
  • ring 5 is designed to contact and deform against the vessel wall and thereby elastically bias the electrode/anchoring section 4 and electrode 10 carried thereon against the vessel wall.
  • the relatively large lumen through the ring permits blood to flow therethrough unimpeded.
  • ring 5 is positioned so as to be tangential to the outer surface of the electrode/anchoring section. This is important in that it defines only a single passageway through the vein once the ring is fitted snugly against the vessel wall, that is the passageway defined through the ring itself. This ensures the largest possible passageway is available for the blood to flow through, minimizing any possible pooling or stagnation of the blood which may lead to thrombus forming.
  • FIG. 5 depicts an alternative embodiment of the present invention.
  • electrode/anchoring section 4 features a tapered, bent elongated nose 16.
  • Nose is preferably constructed integral with and continuous from the electrode/anchoring section.
  • Nose 16 may feature a continuation of the conductor lumen.
  • Nose 16 enhances the steerability and thus ultimate ability of the lead to be properly positioned within the vessel in a manner in which the electrodes make the contact with the desired structures of the heart.
  • the pre shape of the nose determines the ultimate orientation of the lead within the vessel and thus the ultimate orientation of the electrode within the vessel. Selection of a properly shaped nose as well as the orientation of the ring and electrode to the nose thus permits the lead to either communicate with the left atrium, left ventricle or even both left chambers of the heart.
  • FIG. 6 is an alternative embodiment of the present invention. As seen, in this embodiment the ring 5 features the electrode 10. In this fashion, the ring functions to both wedge the distal end of the lead as well as serves as the platform from which the ring contacts the vessel wall.
  • FIGS. 7-10 depict alternative embodiments of the present invention in which the relation between the bent elongated nose, ring and electrode are varied. Through these various configurations the different chambers of the heart may be accessed through the coronary sinus or great cardiac vein.
  • FIGS. 7A and 7B depict an alternative embodiment of the present invention specifically intended for electrically accessing the left atrium.
  • FIG. 7A is a perspective view of this embodiment and shows that ring 5 is positioned more towards the distal end of the lead body than is the electrode 10.
  • this embodiment additionally features a tapered, bent elongated nose 16.
  • FIG. 7B which is a sectional view of the embodiment shown in FIG. 7A taken along the line 7B-7B, ring 5 is disposed at a ninety degree angle relative to nose 16.
  • FIGS. 8A and 8B depict an alternative embodiment of the present invention specifically intended for electrically accessing the left ventricle.
  • FIG. 8A is a perspective view of this embodiment and shows that ring 5 is positioned more towards the distal end of the lead body than is the electrode 10.
  • FIG. 8B which is a sectional view of the embodiment shown in FIG. 8A taken along the line 8B-8B, ring 5 is disposed at a ninety degree angle relative to nose 16, and on the opposite side as compared to the embodiment shown in FIG. 7A.
  • FIGS. 9A and 9B depict an alternative embodiment of the present invention specifically intended for electrically accessing the either the left atrium or left ventricle, depending upon exactly where and how the lead is implanted.
  • FIG. 9A is a perspective view of this embodiment and shows that ring 5 is positioned more towards the distal end of the lead body than is the electrode 10.
  • FIG. 9B which is a sectional view of the embodiment shown in FIG. 9A taken along the line 9B-9B, ring 5 is disposed on the opposite side to nose 16
  • FIGS. 10A and 10B depict an alternative embodiment of the present invention specifically intended for electrically accessing the either the left atrium or left ventricle, depending upon exactly where and how the lead is implanted.
  • FIG. 10A is a perspective view of this embodiment and shows that ring 5 is positioned more towards the distal end of the lead body than is the electrode 10.
  • FIG. 10B which is a sectional view of the embodiment shown in FIG. 10A taken along the line 10B-10B, ring 5 is disposed on the same side as nose 16.
  • This embodiment also features the electrode 10 positioned on ring 5.
  • electrode 10 may be positioned on any location about the ring, including at position 10, 10' or 10'' to illustrate a few possibilities.
  • the ring would be fashioned from a polymer having a conductor therein. The conductor would thus couple the electrode to the lead body conductor and thus to the pulse generator.
  • FIG. 11 depicts an alternative embodiment of the present invention.
  • lead further features a defibrillation electrode 17 positioned at the distal end.
  • lead body 3 has multiple conductors, one coupled to electrode 10 and a second to electrode 17 as is well known in the art.
  • Defibrillation electrode 17 is also constructed in a manner well known in the art. Through this design it is possible, for example, to pace the left atrium and defibrillate the atria(i.e. both the left and right atrium). It would be further possible to pace the left ventricle and defibrillate both ventricles (for example, through the use of an electrode in the inferior vena cava.)
  • FIG. 12 depicts an alternative embodiment of the present invention.
  • the ring 5 is interrupted and is fashioned from a first arc 5-1 and a corresponding opposing second arc 5-2. These arcs cooperate to lodge or wedge lead into position and cause electrode 10 to contact the vessel wall.
  • Each arc moreover, may be canted or angled relative to lead body as described above and further are similarly dimensioned as the ring 5.
  • the arcs may also incorporate one or more electrodes, represented here as 10',
  • Each of the above described embodiments may further be provided with a surface treatment such as a coating of one or more various compounds or be surface treated to increase biocompatibility.
  • a surface treatment such as a coating of one or more various compounds or be surface treated to increase biocompatibility.
  • Such coating may include heparin or other anti-thrombus agents, for example, as disclosed in the Cahalan et al. U.S. Patent No. 5,229,172 assigned to the assignee of the present invention.
  • the present invention is not limited to use only in pacing leads, and may be employed in the construction of many of various type of therapeutic and diagnostic devices, including defibrillation leads, intended to be disposed within the coronary sinus.
  • the term "lead” is used herein in its broadest sense and includes any stimulation lead or sensing lead, a combination thereof or any other elongate member, such as a catheter, which may usefully be introduced into a body.
  • the present invention has been described in the context of transvenous pacing lead.
  • coronary sinus has been used, this is for purposes of illustration only and it should be understood the present invention is useful in positioning a lead along any portion of the vascular system, including the great cardiac vein, or any of the other numerous veins or even arteries within the body into which a lead may be implanted.

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Electrotherapy Devices (AREA)

Claims (20)

  1. Medizinische elektrische Zuleitung bzw. Leitung mit Mitteln (2) zur elektrischen Kopplung mit einem Impulsgenerator,
    einem Zuleitungskörper (3), der mit den Mitteln zur elektrischen Kopplung gekoppelt ist, wobei der Zuleitungskörper ein erstes Ende, ein zweites Ende und einen einen Leiter zwischen dem ersten Ende und dem zweiten Ende bedeckenden Isolierer aufweist, wobei der Isolierer einen Isoliererdurchmesser aufweist, und
    einem Elektroden-/Verankerungsabschnitt (4), der um das zweite Ende des Isolierers positioniert ist, wobei der Elektroden-/Verankerungsabschnitt eine Elektrode (10) aufweist, die mit dem zweiten Ende des Leiters gekoppelt ist, wobei die Elektrode auf einer ersten Seite des Isolierers positioniert ist, gekennzeichnet durch,
    Ringmittel (5) zur Beibehaltung des Kontaktes der Elektrode (10) mit einer Blutgefäßwand, wobei die Ringmittel einen Ringmittelaußendurchmesser aufweisen, wobei der Ringmittelaußendurchmesser größer als der Isoliererdurchmesser ist.
  2. Medizinische elektrische Zuleitung nach Anspruch 1, bei dem der Zuleitungskörper (3) eine Mittelachse aufweist, die Ringmittel (5) eine Mittelachse aufweisen, und die Ringmittel-Mittelachse in einen schiefen Winkel bezüglich der Zuleitungskörper-Mittelachse angeordnet ist.
  3. Medizinische elektrische Zuleitung nach einem der Ansprüche 1 oder 2, bei dem die Ringmittel (5) an einem Punkt bzw. Ort entlang des Zuleitungskörpers (3) gegenüber bzw. entgegengesetzt zu der Elektrode (10) angeordnet sind.
  4. Medizinische elektrische Zuleitung nach einem der Ansprüche 1, 2 oder 3, bei der die Ringmittel (5) einen kreisförmigen Polymerring aufweisen, wobei die Ringmittel um den Elektroden-/Verankerungsabschnitt (4) bzw. tangential zu diesem angeordnet sind.
  5. Medizinische elektrische Zuleitung nach einem der vorstehenden Ansprüche, bei der die Ringmittel (5) eine Dicke von etwa 0,5 bis 3 mm aufweisen.
  6. Medizinische elektrische Zuleitung nach einem der vorstehenden Ansprüche, bei der der Außendurchmesser der Ringmittel (5) etwa 6 bis 8 mm und der Isoliererdurchmesser etwa 1 bis 3 mm beträgt.
  7. Medizinische elektrische Zuleitung nach einem der vorstehenden Ansprüche, bei der der Elektroden-/Verankerungsabschnitt (4) ein distales Ende aufweist, wobei das distale Ende eine gebogene Nase (16) aufweist, wobei die Ringmittel (5) proximal zu der gebogenen Nase angeordnet sind.
  8. Medizinische elektrische Zuleitung nach einem der vorstehenden Ansprüche 1 oder 2, bei der die Ringmittel (5) an einem Punkt bzw. Ort entlang des Zuleitungskörpers, der distaler als die Elektrode (10) ist, angeordnet sind.
  9. Medizinische elektrische Zuleitung nach einem der vorstehenden Ansprüche, bei der die Ringmittel (5) eine Breite von etwa 0,5 bis 4 mm aufweisen.
  10. Medizinische elektrische Zuleitung nach einem der vorstehenden Ansprüche, bei der die Ringmittel (5) sich von einer ersten Seite des Isolierers erstrecken, und die Ringmittel eine kreisförmige Spanne bzw. Überspannung eines biokompatiblen Materials aufweisen.
  11. Medizinische elektrische Zuleitung mit
    Mitteln (2) zur elektrischen Kopplung mit einem Impulsgenerator; und
    einem Zuleitungskörper (3), der mit den Mitteln zur elektrischen Kopplung gekoppelt ist, wobei der Zuleitungskörper ein erstes Ende und ein zweites Ende und einen einen Leiter zwischen dem ersten Ende und dem zweiten Ende bedeckenden Isolierer aufweist, wobei der Isolierer einen Isoliererdurchmesser aufweist, wobei der Zuleitungskörper eine Elektrode (10) aufweist, die mit dem zweiten Ende des Leiters gekoppelt ist, wobei die Elektrode auf einer ersten Seite des Isolierers positioniert ist, gekennzeichnet durch
    Bogenmittel (5-1, 5-2) zur Aufrechterhaltung eines Kontaktes der Elektrode mit einer Blutgefäßwand, wobei die Bogenmittel ein Paar gegenüberliegend bzw. entgegengesetzt angeordneter Bögen aufweist, die sich von einer Seite des Isolierers in einer Richtung um den Zuleitungskörper erstrecken.
  12. Medizinische elektrische Zuleitung nach Anspruch 11, bei der der Zuleitungskörper (3) eine Mittelachse aufweist, die Bogenmittel (5-1, 5-2) eine Mittelachse aufweisen, und die Bogenmittel-Mittelachse in einen schiefen Winkel bezüglich der Zuleitungskörper-Mittelachse angeordnet ist.
  13. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 oder 12, bei der die Bogenmittel (5-1, 5-2) an einem Punkt bzw. Ort entlang des Zuleitungskörpers, der gegenüber bzw. entgegengesetzt zu der Elektrode (10) ist, angeordnet sind.
  14. Medizinische elektrische Zuleitung nach einem der Ansprüche 11, 12 oder 13, bei der die Bogenmittel einen kreisförmigen bzw. kreisartigen Polymerbogen aufweisen, wobei die Bogenmittel um den Zuleitungskörper (3) und tangential zu diesem angeordnet sind.
  15. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 bis 14, bei der die Bogenmittel eine Dicke von etwa 0,5 bis 3 mm aufweisen.
  16. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 bis 15, bei der der Außendurchmesser der Bogenmittel etwa 6 bis 8 mm und der Durchmesser des Isolierers etwa 1 bis 3 mm beträgt.
  17. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 bis 16, bei der der Leitungskörper einen Elektroden-/Verankerungsabschnitt (4) mit einem distalen Ende aufweist, wobei das distale Ende eine gebogene Nase (16) aufweist, und die Bogenmittel proximal zu der gebogenen Nase angeordnet sind.
  18. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 oder 12, bei der die Bogenmittel an einem Punkt bzw. Ort entlang des Zuleitungskörpers angeordnet sind, der distaler als die Elektrode (10) ist.
  19. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 bis 18, bei der die Bogenmittel eine Breite von etwa 0,5 bis 4 mm aufweisen.
  20. Medizinische elektrische Zuleitung nach einem der Ansprüche 11 bis 19, bei der die Bogenmittel sich von einer ersten Seite des Isolierers erstrecken, und wobei die Bogenmittel eine kreisförmige Spanne bzw. Überspannung aus einem biokompatiblen Material aufweisen.
EP98942218A 1997-09-25 1998-08-21 Medizinische elektrische zuleitung Expired - Lifetime EP1017447B1 (de)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US937510 1997-09-25
US08/937,510 US6006122A (en) 1997-09-25 1997-09-25 Medical electrical lead
PCT/US1998/017478 WO1999015230A1 (en) 1997-09-25 1998-08-21 Medical electrical lead

Publications (2)

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EP1017447A1 EP1017447A1 (de) 2000-07-12
EP1017447B1 true EP1017447B1 (de) 2004-04-28

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US (1) US6006122A (de)
EP (1) EP1017447B1 (de)
AU (1) AU9032298A (de)
DE (1) DE69823530T2 (de)
WO (1) WO1999015230A1 (de)

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EP1017447A1 (de) 2000-07-12
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DE69823530T2 (de) 2005-02-03
WO1999015230A1 (en) 1999-04-01

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